Politico’s Kendra Marr and Kate Nocera review the health care records of the GOP presidential candidates and find that Mitt Romney isn’t the only contender who previously supported parts of the Affordable Care Act. Tim Pawlenty, Jon Huntsman, and Newt Gingrich all flirted with various provisions that ultimately ended up in the health law.

ThinkProgress Health reported on Pawlenty’s past support for “universal coverage” here, and his positive assessment of Massachusetts’ individual mandate, but Cal Ludeman, his commissioner of the Minnesota Department of Human Services, recalls that Pawlenty also advocated for establishing an exchange:

Minnesota’s exchange proposal would have required all employers with more than 10 employees to create a “section 125 plan” so workers could buy cheaper insurance with pre-tax dollars. During a 2007 news conference, Pawlenty said launching such a system would only cost employers about $300.

“Remember how new that idea was, even back then,” said Ludeman. “Everybody was talking about how this was a new Orbitz or Travelocity, where you just go shop. It was never talked about in our conversations as a hard mandated only channel where you could go. But that’s where Massachusetts ended up.”

Pawlenty advanced the non-profit Minnesota Insurance Exchange in 2007, arguing that it could “connect employers and workers with more affordable health coverage options.” “If just two of your employees go out and buy insurance through the exchange, the benefits to the employer on a pre-tax basis — because of their payments to Social Security and otherwise into the 125 plan — more than cover the cost of setting up the plan,” Pawlenty explained.

The exchange originated as a Republican idea and was developed in part by the Heritage Foundation’s Stuart Butler. The measure was eventually adopted by Mitt Romney and later became part of the Democrats’ health reform plan. Under the Affordable Care Act, states that don’t establish their own exchanges by 2014, cede control of the new health market places to the federal government. In 2010, while still governor of Minnesota, Pawlenty rejected the ACA’s “insurance exchanges,” dubbing them a federal takeover.

The Wall Street Journal’s Emily Chasan is making the case that, despite any methodology problems in what is now a highly suspicious report from McKinsey about employers dropping coverage as a result of the Affordable Care Act, some employers may still stop providing insurance:

But some executives say it’s natural that companies will seek to avoid getting locked into escalating health-care costs. “The employers know that their costs will only continue to increase at the same unsustainable rate,” said Bryce Williams, President and CEO of Extend Health, which runs a national Medicare exchange used by corporations for retiree health care. “This is a function of health-care inflation that employers have been forced to take on over the past few decades. The reform bill for the first time gives employers an interesting outlet.” [...]

For some companies, paying the fixed cost of a penalty may be more palatable than facing rapidly rising premiums from insurance companies, that may rise even higher, if insurers and hospitals need to pass along higher costs. Some companies may worry that in a more government-driven insurance market, insurance carriers and medical providers may have nowhere else to turn but to them to make up for shortfalls in funding.

There is a certain degree of volatility in the employer-based insurance market, and the Affordable Care will provide both employers and employees with more choices and new decisions. The important point is that if a company does stop offering coverage, its employees will be able to shop around for affordable insurance in the exchanges.

For all its problems, the employer sponsored health care system provides stable coverage to millions of Americans and will likely remain a key source of insurance in the years ahead. While some progressives have proposed severing the link between employment and health care, others see any sudden shift as impractical. They point to the logistical nightmare of having to transfer millions of people into relatively untested exchanges in a relatively short period of time and the political problems that are associated with people being fairly satisfied with the insurance they currently have. The Affordable Care Act will provide for a far more gradual shift, one that keeps pace with Americans’ comfort level for new insurance options.

Congressional Republicans are hoping to give states more discretion over their Medicaid programs and ideally push beneficiaries into private sources of insurance coverage. They argue that the program’s costs are growing at an unsustainable rate and that Medicaid’s structure and lower provider reimbursement rates undermine patients’ access to quality care. The party has gone so far as to suggest that people are better off uninsured than insured under Medicaid and has described the program as a “medical ghetto.”

But a new report from First Focus highlights the importance of Medicaid in providing cost efficient coverage to lower income patients who “face elevated health risks.” Medicaid typically offers “a broader range of services, including preventive care and special services needed by those with disabilities or other chronic conditions” at access levels that are actually “comparable to access provided under private health insurance and far better than access available to the uninsured.” Despite the GOP’s claims, “almost all children covered by Medicaid or CHIP children have a usual source of care” and “about nine out of ten publicly- and privately-insured adults had a usual source of care, compared to less than half of uninsured adults”:

Moreover, “after controlling for health status, age, gender, income, and other factors, the average per person annual cost of serving an adult on Medicaid was 20 percent less than under private insurance and the annual cost of serving a child on Medicaid or CHIP was 27 percent less than under private insurance”:

The report also notes that Medicaid’s cost sharing limits — “low out-of-pocket copayments, deductibles or premiums – compared to private insurance” play an important role in preserving access to coverage and keeping lower income families from being pushed out of insurance by escalating health care costs.

Rep. Paul Ryan’s budget reduces Medicaid funding by $1.4 trillion over the next decade and transforms the existing financing mechanism into a block grant that does not keep up with projected health care costs. As a result, a recent Kaiser Family Foundation report estimated that up to 44 million Medicaid beneficiaries could be pushed out of the program.

Blue Arkansas catches Rep. Rick Crawford (R-AR) — who had previously bragged about his vote to repeal the Affordable Care Act — noting that parts of the measure should remain in law:

First Congressional District Congressman Rick Crawford said the fervor among congressional Republicans to overturn the national health-care bill passed in March 2010 has waned, and there are parts of the plan that should remain law.

Crawford, R-Ark., of Jonesboro toured Lawrence County Memorial Hospital on Thursday morning and then met with physicians, board members and other hospital officials afterward.

“I don’t want to discuss this on a partisan basis by saying all of Obamacare is bad,” Crawford said. He gave few details about what parts of the law he supports or which ones need to be overturned.

Republicans have tried to argue that they support parts of the Affordable Care Act, even as they seek to repeal all of it. During one recent event in New Hampshire, presidential candidate Newt Gingrich said, “I’m happy to concede out of 2,800 pages, at least 200 are good. But the bill overall is a disaster and we’re better off to take the 200 pages and pass them later, separately, having gotten rid of Obamacare.”

During yesterday’s appearance on Meet the Press, Rick Santorum regurgitated this nugget of Republican conventional wisdom: “We need a more comprehensive plan where seniors and individuals are involved in controlling costs. And you have government now controlling well over 50 percent of medical care, and they’re not doing a very good job controlling costs.”

The truth is that government health care spending has dramatically increased in the last decades — but at a far slower pace than private health costs. As Paul Krugman pointed out in his column, while inflation-adjusted Medicare spending per beneficiary rose “more than 400 percent from 1969 to 2009, premiums on private health insurance rose more than 700 percent over the same period.” “So while it’s true that Medicare has done an inadequate job of controlling costs, the private sector has done much worse,” he concludes:

Medicare’s smaller administrative spending and its ability to use its sheer size and clout to bargain for cheaper services explain this advantage. In fact, “if Medicare costs had risen as fast as private insurance premiums, it would cost around 40 percent more than it does. If private insurers had done as well as Medicare at controlling costs, insurance would be a lot cheaper,” Krugman writes.

In the face of all this data, Santorum still wants to privatize Medicare and ask today’s seniors to purchase private coverage with a voucher. He opposes all of the Affordable Care Act’s provisions that address his criticism and control Medicare costs and so he is very hard to take seriously.